Many of us speak multiple languages. The most common of which include Spanish, French and, in South Florida, Portuguese! Some of us speak a language that is not so common and we tend to forget that those we are talking to may not understand a lot of what we are telling them. One of those languages is “Optometry/Opticianry” and the poor folks that are left befuddled when we speak it to them are you all. The patients.
The words that we throw at you like a Sandy Koufax fastball roll off our tongues with abandon. And we tend to not notice the glaze that appears over your eyes as we enthusiastically ramble on. What we have here is a very basic primer that will, hopefully, help you get the gist of what the heck we’re talking about!
Let’s start with the basics:
OPTOMETRIST: Very simply put, an optometrist is an eye doctor. They can be referred to as Optometric Physicians. Optometrists – or ODs – are able to prescribe medications, examine the health of the eye, diagnose and treat certain injuries and medical conditions of the eye, as well as identify systemic conditions that may show early symptoms within the eye.
And, they prescribe glasses and contact lenses, as well.
OPHTHALMOLOGISTS: They are Osteopaths, or MDs. Their specialty is managing advanced eye disease and performing surgical procedures. Ophthalmologists offer prescriptions for glasses and contact lenses too, but that is not their primary focus.
OPTICIAN: An optician is the person who will assist you in selecting a frame and lens combination that will best suit your needs. They are not doctors, but they know how to take what the optometrist has prescribed and finagle all of that information into something that will both fit your optical needs and make you look amazing in the process!
So, now that we have the cast of characters straightened out, let’s look at some of the technical mumbo-jumbo that can really confuse you. We’ll start with a quick anatomy lesson, then go on to some of the instruments that are used to give you a good, comprehensive exam.
Buckle up. Here we go!
CORNEA: The cornea is the clear “bubble” that covers the colored part of your eye – the iris – and the black hole in the center – the pupil. Though small and clear, it is a complex part of your eye’s function and it is the first line of defense against injury after your eyelids. It is also the “contact” point for a contact lens.
IRIS: The iris is the colored part of your eye. Besides giving you blue, brown, hazel or green eyes, it also controls the…
PUPIL: The pupil is the black spot in the center of the iris. Well, it is actually a hole. Combined with the iris, it decides how much or how little light reaches the back of the eye which is called the…
RETINA: The retina is where the cool stuff really starts happening! It’s a thin layer of very sensitive tissue composed of tiny blood vessels and things called “photoreceptor cells”. These cells take the light that comes in through the pupil and translates that light into color and, eventually, objects once it has traveled to your brain via the…
OPTIC NERVE: The optic nerve carries all the information collected by the retina to the brain so we can pull everything together and identify the images that are sent to it. Though technically part of the eye, the optic nerve is anatomically regarded as part of the central nervous system.
MACULA: The macula is the center of our vision. It’s the spot in the retina where the sharpest and most detailed part of the image is processed. The surrounding retina gives us our peripheral vision.
Now, on to the instruments that we use to give you a good, comprehensive eye exam.
PHOROPTER: This is the instrument that Dr Kay or Dr Deweese places in front of your face and asks, “What’s better? Number one or number two?”, as he flips through a series of lenses. Using the phoropter, the doctor performs the…
REFRACTION: The refraction determines what your best corrected visual acuity – or sharpness of vision – is. This gives the doctor the information needed to calculate your prescription.
RETINAL IMAGING: In very basic terms, this is a photograph of the back of your eye – the retina. These high-definition images show the doctors what is going on inside your eye – the health of the retina, macula, optic nerve and blood vessels. We like to do retinal imaging because the “picture” becomes a permanent part of your record. It gives the doctors a detailed look at what is going on at that point in time and it gives them a reference for future visits. If they see something on a later visit, they can compare past images to see whether it has always been there and, if it has, whether it has changed or if it is something new that needs further exploration.
TONOMETRY: Ah! The dreaded air puff! We at Hollywood Eyes don’t use the puff test. The doctors have other ways to obtain the information that the air puff – or non-contact tonometer – provides without blowing air onto your eyes. So, what is the purpose? We use tonometry to measure the pressure created by the fluid within the eye. Elevated intraocular pressure – or IOP – is sometimes a symptom of glaucoma. The doctors use IOPs in conjunction with other signs to diagnose – or rule out – glaucoma.
OPTICAL COHERENCE TOMOGRAPHY: Or OCT. OCT is a non-invasive scan similar to an MRI. The instrument uses light waves to create a cross-section map of what is going on behind the visible surface of the retina. It allows the doctor to see if there are any holes or tears or any fluid accumulation, bleeding or swelling that can potentially threaten your vision.
Hollywood Eyes offers the OCT and Retinal Imaging to our patients at the time of your comprehensive eye exam. Ask us if we don’t ask you first!
Now, we will explain some of the terminology associated with your glasses.
PUPILLARY DISTANCE: Or PD. The PD is the distance from the center of one pupil to the center of the other. Or, from the center of the pupil to the center of the bridge of your nose. We need an accurate PD to properly design your eyeglass lenses. Your PD tells us where to place the clearest, strongest part of your prescription.
SINGLE VISION LENS: A single vision lens carries the same prescription throughout the entire lens. Generally, for people under 30 to 40 years of age, a single vision lens suits all of their focusing needs. Once we’ve circled the sun a few more times, we either need multiple single vision glasses or a…
PROGRESSIVE ADD LENS: Or PAL or no-line “bifocal”. We’re trying to steer people away from the term “no-line bifocal” because it really does not do this lens justice. Back in the day, progressives could be very difficult to adapt to. But, like any other technology, they have advanced to designs that are very easy to use and require very little, if any, adaptation time.
Now, that being said, progressives are a convenience lens. While they perform well in the majority of situations, some patients do better with a task-specific lens. Say, if they spend a considerable amount of time in front of a computer monitor or do a lot of reading. Like Dr Kay says, you have more than one pair of shoes for multiple situations. Most people do better with more than one pair of glasses.
So. Why do we need vision correction in the first place?
MYOPIA: Myopia is a form of refractive error. It’s caused by the actual shape of the eye and how that shape affects where images are projected. In the case of myopia, the image is projected in such a way that it causes the brain to perceive objects at a distance as being blurry. Focusing up close is generally much easier.
HYPEROPIA: The opposite of myopia is hyperopia. Hyperopia causes the image to be projected in such a way that the brain perceives objects that are close as blurry. Often, distance vision is not a problem.
ASTIGMATISM: Myopic and hyperopic patients might also have astigmatism. It can also stand on its own as a refractive error. With astigmatism, your cornea is irregularly shaped rather than being a smooth, semi-sphere. This irregularity causes light to bend in such a way that it does not focus correctly on the retina.
PRESBYOPIA: Once again, as we circumnavigate the sun, our bodies change. So do our eyes. The word itself comes from the Greek word that translates to “old eye”. Most people start noticing changes in their ability to focus up close in their late 30s or early 40s. Most of us are in denial about these changes until our arms become too short to allow us to see our cell phones and restaurant menus clearly.
As we navigate through life, the eye’s natural lens – located behind the iris and pupil – becomes stiff. Kind of like our knees. This rigidity prevents the lens from bending which it has to do to allow us to focus at close range. This is when we begin to need progressive lenses.
Like any other specialized field, optometry, ophthalmology and opticianry become easier to understand once we have the language explained to us. Hopefully, this has helped a little to get you on track.
Feel free to let us know if there is anything else that we can help you understand! Once we get an idea of what’s going on, the little orbs on either side of your nose that are only a little more than half the size of a ping pong ball, take on a life of their own. It’s amazing what goes on inside that little ball!